Med Surg Unit 1 & 2 (Test 1) (Oncology Management and Hematologic Function)

True or False: Secondary polycythemia is caused by excessive production of erythropoietin.

true

True or false: X-ray can cause cancer?

true

neoplasia

uncontrolled cell growth that follows no physiologic demand; cancer

What is the most lethal chemical carcinogen?

tobacco

30% of all cancer-related deaths are related to _________

tobacco use

Patients who have had a partial or total gastrectomy may have limited amounts of intrinsic factor, therefore the absorption of vitamin _______ may be diminished.

B12

A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client?

Monitor the client to prevent sepsis.

Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?

Myeloid stem cell

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate?

Neurologic involvement

A client with a diagnosis of pernicious anemia comes to the clinic reporting of numbness and tingling in his arms and legs. What do these symptoms indicate?

Neurologic involvement

An increase in _______________ may be seen in patients exposed to a bacterial infection.

Neutrophils

Which of the following is the most common hematologic condition affecting elderly patients

Anemia

Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?

Allogeneic

Which is a sign or symptom of septic shock?

Altered mental status

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?

"DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

While doing a health history, a client tells the nurse that her mother, her grandmother, and her sister died of breast cancer. The client asks what she can do to keep from getting cancer. What is the best response by the nurse?

"Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level."

What are some general effects of malignant cells?

Anemia, weakness, systemic inflammation, weight loss, and CACS

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms?

"Eat small amounts of bland, soft foods frequently."

An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful?

"I clean my teeth gently several times per day."

A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?

"I understand your concern. The blood is carefully screened but is not completely risk free."

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching?

"I'll eat four servings of fresh, dark green vegetables every day."

A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit?

"I'll play card games with my friends."

Which statement by a client undergoing external radiation therapy indicates the need for further teaching?

"I'm worried I'll expose my family members to radiation."

A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse?

"It will allow time for the repair of healthy tissue."

Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse?

"The child must inherit two defective genes, one from each parent."

A nurse cares for a client with megaloblastic anemia who had a total gastrectomy three years ago. What statement will the nurse include in the client's teaching regarding the condition?

"The condition is likely caused by a vitamin B12 deficiency."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?

"The hair loss is usually temporary."

A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse?

"The surgeon is going to use liquid nitrogen to freeze the area."

A nurse is caring for a client who will undergo total knee replacement and will have an autologous transfusion. Which statement will the nurse include when teaching the client about the transfusion?

"You typically donate blood 4 to 6 weeks before the surgery."

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is

"You will need to practice birth control measures."

nadir

-the lowest point of something -the lowest serum level of blood cells

How many different types of cancer is cigarette smoking strongly associated with?

12

Delayed hemolytic reactions usually occur within _________ days after transfusion, when the level of antibody has been increased to the extent that a reaction can occur.

14

The client has a body surface area of 2.05 m². He is prescribed vincristine (Oncovin) 1.4 mg/m². Vincristine is available as 1 mg/1 mL. How many mL will the nurse administer? Round your answer to the nearest tenth.

2.9

Which client is not a candidate to be a blood donor according to the American Red Cross?

26-year-old female with hemoglobin 11.0 g/dL

A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?

4:00 pm

A nurse is preparing a dose of furosemide for an older adult with heart failure. The health care provider orders furosemide 1 mg/kg to be given intravenously. The client weighs 50 kg. The concentration of the drug is 40 mg/4mL (10 mg/mL). How many milliliters would the nurse administer? Record your answer using a whole number.

5

A health care provider prescribes one tablet of ferrous sulfate daily for a 15-year-old girl who experiences heavy blood flow during her menstrual cycle. The nurse advises the patient and her parent that this over-the-counter preparation must be taken for how many months before stored iron replenishment can occur?

6-12 months

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication?

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthl

A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?

Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

A client's low prothrombin time (PT) was attributed to low vitamin K levels and the client's PT normalized after administration of vitamin K. When performing discharge education in an effort to prevent recurrence, what should the nurse emphasize?

Adequate nutrition

A client is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which nursing intervention is appropriate for the client?

Adjusting the client's meal plan before and after chemotherapy

A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?

Administer acetaminophen 500 mg po, as ordered

A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take?

Administer the prescribed enoxaparin (Lovenox).

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention?

Administering and evaluating the effectiveness of opioid analgesics

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?

Administering metoclopramide and dexamethasone as ordered

Plasma proteins consist primarily of __________ and globulins.

Albumin

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse?

Assesses the hemoglobin level

A nurse cares for a client with anemia requiring nutritional supplementation. Which nursing intervention best promotes client adherence with the prescribed therapy?

Assist the client to incorporate the therapeutic regimen into daily activities.

The nurse is planning care for a client with severe fatigue secondary to anemia. What concept will the nurse use as the basis for planning interventions?

Assisting in prioritizing activities.

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?

Avoid spicy and fatty foods.

A patient describes numbness in the arms and hands with a tingling sensation. The patient also frequently stumbles when walking. What vitamin deficiency does the nurse determine may cause some of these symptoms?

B12

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods?

Beans, dried fruits, and leafy, green vegetables

Which of the following are assessment findings associated with thrombocytopenia? Select all that apply.

Bleeding gums Epistaxis Hematemesis

Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?

Blood studies

The nurse is educating a client about iron supplements. The nurse teaches that what vitamin enhances the absorption of iron?

C

A nursing instructor in a BSN program is preparing for a lecture on disorders of the hematopoietic system. Included in the lecture are conditions caused by reduced levels or absence of blood-clotting proteins. Which of the following is the instructor most likely referring to?

Coagulopathy

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order?

CBC

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

Which oncologic emergency involves the accumulation of fluid in the pericardial space?

Cardiac tamponade

A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse

Checks the client's BUN and creatinine

What are some examples of carcinogens?

Cigarettes, UV rays, asbestos

A client is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met?

Closely monitor intake and output.

A nurse working with clients diagnosed with sickle cell disease notices that sickle cell crisis cases increase in the winter months. What is the primary pathophysiological reason for this?

Colder temperatures slows the blood flow.

A male client has been receiving a continuous infusion of weight-based heparin for more than 4 days. The client's PTT is at a level that requires an increase of heparin by 100 units per hour. The client has the laboratory findings shown above. What is the most important action for the nurse to take?

Consult with the physician about discontinuing heparin.

The nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?

Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart.

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?

Control

Post transfusion, the donor stands up immediately after the needle is withdrawn. The nurse should be alert for which vital sign change?

Decreased blood pressure.

The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level?

Decreased oxygen level.

The drug interleukin-2 is an example of which type of biologic response modifier?

Cytokine

Tissue of origin of Leukemia

Hematopoietic cells in the bone marrow

The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions?

Dilute the liquid preparation with another liquid such as juice and drink with a straw.

The charge nurse should intervene when observing a new nurse perform which action after a client has suffered a possible hemolytic blood transfusion reaction?

Disposing of the blood container and tubing in biohazard waste.

You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?

Drink at least 8 glasses of water every day.

The nurse and the client are discussing some strategies for ingesting iron to combat the client's iron-deficiency anemia. Which is among the nurse's strategies?

Drink liquid iron preparations with a straw.

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?

Eating calf's liver with a glass of orange juice

What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?

Encourage fluid intake to dilute the urine.

A client receiving a blood transfusion reports shortness of breath, appears anxious, and has a pulse of 125 beats/minute. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the health care provider?

Ensure there is an oxygen delivery device at the bedside.

A client is prescribed an intravenous dose of iron dextran. What is the nurse's best action?

Ensures that epinephrine is available

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia?

Erythrocytes that are microcytic and hypochromic

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this client?

Erythropoietin

A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?

Essential thrombocythemia

What are some physical factors associated with carcinogenesis?

Exposure to sunlight, radiation, chronic irritation or inflammation, tobacco use, industrial chemicals, asbestos

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication?

Extravasation

True or False: In hypoproliferative anemias, premature destruction of erythrocytes results in the liberation of hemoglobin from the erythrocytes into the plasma.

False

True or False: Patients with seed implants typically are not able to return home; radiation exposure to others is likely.

False

True or false: The average lifespan of a normal circulating erythrocyte is 60 days or about 2 months.

False

True or false: The most common type of blood transfusion reaction is an allergic reaction that causes urticaria.

False

True or false: To be considered a blood donor, a man must have a minimum hemoglobin level of 12 g/dL.

False

True or flase: Pain and fatigue are the two most common side effects of chemotherapy.

False

A client was admitted to the hospital with the following laboratory values: hemoglobin 5 g/dL, leukocyte count 2000/mm3, and a platelet count of 48,000/mm3; abnormally shaped erythrocytes and hypersegmented neutrophils were seen. The platelets appear abnormally large. A bone marrow biopsy was competed and revealed hyperplasia. Based on this information, the nurse determines that client most likely has which diagnosis?

Folic acid deficiency

What viruses are known to cause cancers?

HPV, HBV, and Epstein-Barr Virus

When assessing a client with anemia, which assessment is essential?

Health history, including menstrual history in women

What are some examples of bacteria that are associated with increased risk of cancer?

Helicobacter pylori (stomach cancer), Salmonella enteritidis (colon cancer), and Chlamydia trachomatis (ovarian and cervical cancers).

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication?

Hemoglobin level

A client's electronic health record states that the client receives regular transfusions of factor IX. The nurse would be justified in suspecting that this client has what diagnosis?

Hemophilia

A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?

Hemorrhage

A client is scheduled for surgery to remove an abdominal mass. The nurse knows that which reason hemodilution would be contraindicated as a method to provide blood to the client during the surgery?

History of renal disease

The three biopsy methods used to obtain a tissue sample for histologic analysis of possible malignant cells are excisional, _____________, and needle methods.

Incisional

A nurse provides nutritional information for a patient diagnosed with an iron-deficiency anemia. What education should the nurse provide?

Increase the intake of green, leafy vegetables.

A client is receiving platelets. In order to decrease the risk of circulatory overload in this client, what action should the nurse take?

Infuse each unit over 30-60 minutes per client tolerance.

While completing an admission assessment, the client reports a family history of breast cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?

Inherited gene mutation

The nurse is caring for a client who has a unit of whole blood removed every 6 weeks as treatment for polycythemia vera. Which laboratory test will the nurse monitor to determine if the procedure is adversely affecting the client?

Iron

The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned the co-worker may have?

Iron deficiency anemia

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?

It lowers serum and uric acid levels.

The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy?

It removes a wedge of tissue for diagnosis.

What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?

It targets normal body cells as well as cancer cells.

Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat?

Lamb and peaches

The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?

Lateral position with one leg flexed

Which blood cell type is matched correctly with its function?

Leukocyte: Fights infection

hypochromic

Lighter in color than normal

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?

Liver

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?

Liver

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding?

Low ferritin level concentration

Which term refers to a form of white blood cell involved in immune response?

Lymphocyte

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

Malignant tumor

In which phase of the cell cycle does cell division occur?

Mitosis

The body responds to infection by increasing the production of white blood cells (WBCs). The nurse should evaluate the differential count for what type of WBCs, which are the first WBCs to respond to an inflammatory event?

Neutrophils

According to the tumor-node-metastasis (TNM) classification system, T0 means there is

No evidence of primary tumor

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action?

Notify the physician

The nurse provides care for an older adult client, diagnosed with anemia, who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine the cause of the client's blood loss, which is the priority nursing action?

Observe the client's stools for blood.

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron?

Orange juice

A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?

Osteoporosis

A patient receiving plasma develops transfusion-related acute lung injury (TRALI) 4 hours after the transfusion. What type of aggressive therapy does the nurse anticipate the patient will receive to prevent death from the injury? (Select all that apply.)

Oxygen Fluid support Intubation and mechanical ventilation

Which type of surgery is used in an attempt to relieve complications of cancer?

Palliative

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?

Pallor, tachycardia, and a sore tongue

A nurse cares for a client who has had a bone marrow aspiration. In addition to the client's aspiration site, what locations on the body does the nurse recognize as having bone marrow? Select all that apply.

Pelvis Ribs Vertebrae Sternum

A nurse is caring for a client with severe anemia. The client is tachycardic and reports dizziness and exertional dyspnea. What signs and symptoms might develop if this client goes into heart failure?

Peripheral edema

Under normal conditions, the adult bone marrow produces approximately 70 billion neutrophils. What is the major function of neutrophils?

Phagocytosis

A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action?

Place the client in a private room.

A client is diagnosed with extreme thrombocytosis. The nurse knows this condition is a result of which elevated blood cell count?

Platelets

A client awaiting a bone marrow aspiration asks the nurse to explain where on the body the procedure will take place. What body part does the nurse identify for the client?

Posterior iliac crest

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?

Progression

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?

Stage 3 pressure ulcer on the left heel

The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure?

Prophylactic

Which of the following is considered an antidote to heparin?

Protamine sulfate

A nurse assesses an oncology client with stomatitis during a chemotherapy session. Which nursing intervention would most likely decrease the pain associated with stomatitis?

Provide a solution of viscous lidocaine for use as a mouth rinse.

The nurse is screening donors for blood donation. Which client is an acceptable donor for blood?

Reports having a cold 1 month ago that resolved quickly

A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client?

Reports joint pain less than 3 on a scale of 0 to 10

A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction?

Rh-negative mother; Rh-positive child

The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for?

Schilling test

Secondary prevention involves____________

Screening and early detection activities

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with

Seizure

A nurse practitioner reviewed the blood work of a male client suspected of having microcytic anemia. The nurse suspected occult bleeding. Which laboratory result would indicate an initial stage of iron deficiency?

Serum ferritin: 15 ng/mL

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?

Serum potassium level of 2.6 mEq/L

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?

Stomatitis

A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response?

Substances are released when tumor cells are destroyed.

The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks?

Sun safety and use of sunscreen

Which type of lymphocyte is responsible for cellular immunity?

T lymphocyte

A nurse, caring for a client with human immunodeficiency virus (HIV), reviews the client's differential WBC count. What type of WBC will the nurse check the level of?

T lymphocytes

The health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?

T lymphocytes

A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching?

Take 1 hour before breakfast

A client with chronic anemia has received multiple transfusions. Which client action would the nurse be concerned about relative to the client's condition?

Takes over-the-counter iron supplements

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?

The I.V. site is red and swollen.

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss?

The client should consider getting a wig or cap prior to beginning treatment.

The nurse is caring for a client with hypoxia. What does the nurse understand is true regarding the client's oxygen level and the production of red blood cells?

The kidneys sense low oxygen levels in the blood and stimulate erythropoietin, stimulating the marrow to produce more red blood cells.

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for?

The onset of a bacterial infection

metastasis

The spread of cancer cells beyond their original site

A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because:

The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores?

There is a strong correlation between iron stores and hemoglobin levels.

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse?

To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

True or False: Anemia is the most common hematologic condition affecting older adults, particularly those admitted to hospitals or those in long-term care facilities.

True

True or False: Iron deficiency anemia, the most common type of anemia in all age groups, also is the most common anemia in the world.

True

True or False: The patient with sickle cell trait usually has a normal hemoglobin level, a normal hematocrit, and a normal blood smear.

True

True or false: Environmental tobacco smoke (ETS), otherwise known as secondhand smoke, has been linked to lung cancer; nonsmokers who live with a smoker have about a 20% to 30% greater risk of developing lung cancer.

True

True or false: Genetic mutations may lead to abnormalities in cell signaling transduction processes that can in turn lead to cancer development.

True

True or false: The patient, who is experiencing severe circulatory overload due to too much blood infusing too quickly, should be placed in an upright position with the feet in a dependent position.

True

True or false: The primary function of lymphocytes is to attack foreign material.

True

A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which would not be included in the client's discharge instructions?

Use a disposable razor when shaving.

While caring for a client, the nurse notes petechiae on the client's trunk and lower extremities. What precaution will the nurse take when caring for this client?

Use an electric razor when assisting client with shaving.

The physician orders a transfusion with packed red blood cells (RBCs) for a client hospitalized with severe iron deficiency anemia. When blood is administered, what is the most important action the nurse can take to prevent a transfusion reaction?

Verify the client's identity according to hospital policy

During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin?

Vitamin K

Which medication is the antidote to warfarin?

Vitamin K

A young client is diagnosed with a mild form of hemophilia and is experiencing bleeding in the joints with pain. In preparing the client for discharge, what instructions should the nurse provide?

Wear a medical identification bracelet.

The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line

With a soft, plastic catheter

cancer

a group of disorders characterized by abnormal cell proliferation, in which cells ignore growth-regulating signals in the surrounding environment

apoptosis

a normal cell mechanism of programmed cell death

When the immune system fails to identify and stop the growth of transformed cells, what happens?

a tumor can develop and progress

neutropenia

abnormally low absolute neutrophil count

Most hazardous chemicals produce their toxic effects by_______________

altering DNA structure

graft-versus-host disease (GVHD)

an immune response initiated by T lymphocytes of donor tissue against the recipient's tissues (skin, gastrointestinal tract, liver); an undesirable response

toxicity

an unfavorable and unintended sign, symptom, or condition associated with cancer treatment

Which is a symptom of hemochromatosis?

bronzing of the skin

carcinogens

chemicals, physical factors, and other agents that cause cancer

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include:

chemotherapy exposure and risk factors.

Disseminated intravascular coagulation (DIC) is characterized by a process of inflammation and _______________ within the vasculature.

coagulation

The leading causes of cancer death in the United States, for men, are lung, prostate, and _________ cancers.

colorectal

Tissue of origin of Sarcoma

connective tissue

thrombocytopenia

decrease in the number of circulating platelets; associated with the potential for bleeding

brachytherapy

delivery of radiation therapy through internal implants placed inside or adjacent to the tumor

anaplasia

pattern of growth in which cells lack normal characteristics and differ in shape and organization with respect to their cells of origin; usually, anaplastic cells are malignant

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply.

dietary substances environmental factors viruses

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice?

eats red meat such as steaks or hamburgers every day

tertiary prevention focuses on___________

efforts focus on monitoring for and preventing recurrence of the primary cancer as well as screening for development of secondary malignancies in cancer survivors

A cluster of symptoms referred to as _______________ syndrome may occur during the neutrophil recovery phase in both allogeneic and autologous transplants.

engraftment

The tissue of origin for carcinomas is

epithelium

The most common symptom and complication of anemia is _________, which has the greatest negative impact on a patient's level of functioning.

fatigue

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of

graft-versus-host disease.

angiogenesis

growth of new blood vessels that allow cancer cells to grow

alopecia

hair loss

malignant

having cells or processes that are characteristic of cancer

____________________ is a genetic condition in which excess iron, absorbed from the GI tract, is deposited in various body organs.

hemochromatosis

grading

identification of the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin

An example of primary prevention is the use of___________

immunizations

A patient with neutropenia is at an increased risk for __________, which increases proportionately with the decrease in the neutrophil count.

infection

mucositis

inflammation of the lining of the mouth, throat, and gastrointestinal tract often associated with cancer therapies

stomatitis

inflammation of the oral tissues, often associated with some chemotherapeutic agents and radiation therapy to the head and neck region

Patients with __________ anemia develop a smooth sore red tongue.

pernicious

extravasation

leakage of intravenous medication from the veins into the subcutaneous tissues

A client with sickle cell anemia has a

low hematocrit

tissue of origin of lymphoma

lymphocytes

Which is a growth-based classification of tumors?

malignancy

Bone ___________ is the primary site for hematopoiesis, a process of continuous blood cell formation.

marrow

cytokines

messenger substances that may be released by a cell to create an action at that site or may be carried by the bloodstream to a distant site before being activated; (synonyms: biochemical mediators, inflammatory mediations)

________________ antibodies are a form of immunotherapy that enables investigators to grow and produce antibodies for specific malignant cells

monoclonal

benign

not cancerous; benign tumors may grow but are unable to spread to other organs or body parts

A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them:

onto the bedpan.

What 12 cancers are strongly associated with cigarette smoking?

oral and pharynx, larynx, lung, esophagus, pancreas, uterine cervix, kidney, bladder, stomach, colorectal, liver, and myeloid leukemia.

Smokeless tobacco products are associated with an increased risk of what cancers?

oral, pancreatic, and esophageal

While assessing a client, the nurse will recognize what as the most obvious sign of anemia?

pallor

Tissue of origin of Myeloma

plasma cells

staging

process of determining the extent of disease, including tumor size and spread or metastasis to distant sites

carcinogenesis

process of transforming normal cells into malignant cells

palliation

relief of symptoms and promotion of comfort and quality of life regardless of the disease stage

microcytic

smaller than normal cell size

A complete diagnostic evaluation of a cancerous tumor includes pathology analysis, which is used to identify the __________ and grade of a tumor.

stage

oncology

study of cancer

vesicant

substance that can cause inflammation, damage, and necrosis with extravasation from blood vessels and contact with tissues

myelosuppression

suppression of the blood cell-producing function of the bone marrow

An oncology nurse is caring for a client who is taking antineoplastic agents. What symptoms would the nurse consider with tumor lysis syndrome when monitoring this client?

symptoms of gout

In the United States, carcinogens are classified by two federal agencies:

the National Toxicology Program of the Department of Health and Human Services (HHS) and the Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS)

graft-versus-tumor effect

the donor immune cell response against the malignancy; a desirable response

radiation therapy

the use of ionizing radiation to kill malignant cells

targeted therapies

the use of medications or other agents to kill or prevent the spread of cancer cells by targeting specific part of the cell, with less negative effects on healthy cells

immunotherapy

the use of medications or other agents to stimulate or suppress components of the immune system to kill cancer cells

chemotherapy

the use of medications to kill tumor cells by interfering with cellular functions and reproduction

The nurse is caring for a client with cancer. The client asks the nurse why colony-stimulating factors are being administered in addition to chemotherapy. Which response by the nurse is appropriate?

to shorten the period of neutropenia

precision medicine

using advances in research, technology, and policies to develop individualized plans of care to prevent and treat disease

It is estimated that 10% to 12% of all cancers worldwide are linked to________

viral infections